Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-18-31366 | CO |
NPI | 1003330564 |
---|---|
Provider Name | Sara L Cook |
First Address | Castle Rock, CO 80104-1505 |
Second Address | Castle Rock, CO 80109-3973 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2017 |
Last Update Date | 24/12/2021 |